M42.1 — Adult osteochondrosis of spine
M42.1 is a non-billable header ICD-10-CM code for adult osteochondrosis of spine. It cannot be billed on its own: choose one of the more specific child codes below.
Other codes that can never be billed with M42.1
These codes carry an Excludes1 note pointing at M42.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading M42.1 alone.
- M40.0Postural kyphosis
Risk adjustment
M42.1 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Code history
M42.1 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Code to one of these instead M42.1
10 child codes. Green means billable.
- M42.10Adult osteochondrosis of spine, site unspecified
- M42.11Adult osteochondrosis of spine, occipito-atlanto-axial region
- M42.12Adult osteochondrosis of spine, cervical region
- M42.13Adult osteochondrosis of spine, cervicothoracic region
- M42.14Adult osteochondrosis of spine, thoracic region
- M42.15Adult osteochondrosis of spine, thoracolumbar region
- M42.16Adult osteochondrosis of spine, lumbar region
- M42.17Adult osteochondrosis of spine, lumbosacral region
- M42.18Adult osteochondrosis of spine, sacral and sacrococcygeal region
- M42.19Adult osteochondrosis of spine, multiple sites in spine
Related codes at this level
Codes that share M42. If M42.1 is not quite right, the correct code is usually one of these.
Questions about M42.1
- Is M42.1 a billable ICD-10-CM code?
- No. M42.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does M42.1 sit in the tabular list?
- Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Deforming dorsopathies (M40-M43).